Moreover, there is sufficient goodq

Moreover, there is sufficient goodquality evidence to support use of appropriate therapeutic footwear with demonstrated pressure relief that is worn by the patient to prevent plantar foot ulcer recurrence or worsening. However, there is very little evidence for the use of interventions to prevent a first foot ulcer or heal ischemic, infected, nonplantar, or proximal foot ulcers (170). Studies on specific types of footwear demonstrated that shape and barefoot plantar pressure based orthoses were more effective in reducing submetatarsal head plantar ulcer recurrence than current standard-of-care orthoses (171). Clinicians are encouraged to review ADA screening recommendations for further details and practical descriptions of how to perform components of the comprehensive foot examination (172).